medications and the recovering person in... · when taken. in addition, if urine drug screening is...

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MEDICATIONS AND

THE RECOVERING

PERSON

Bruce J. Merkin, MD (Medical Director, Glenbeigh Hospital and Clinical

Instructor in Addiction Medicine, Case School of Medicine), Paul H. Earley, MD,

FASAM (Talbott Recovery Campus, Atlanta, GA), Renee Enstrom, Pharm.D.

Candidate (LECOM School of Pharmacy) and Nicholas Link, Pharm.D. Candidate

(Ohio Northern University).

February 2007

C: CD INFO, Medications & the Recovering Person

A guide to maintaining sobriety while receiving treatment for other health problems

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TABLE OF CONTENTS Introduction to Medications & the Recovering Person 3

(AVOID ABSOLUTELY)

Class A (alcohol, antitussives/expectorants, barbiturates) 5

Class A (benzodiazepines, depressants, hallucinogens, inhalants 6

Class A (neuropathic pain, opioids, anti-diarrheals) 7

Class A (other sedative-hypnotics, stimulants 8

(ONLY TAKE WITH DOCTOR’S APPROVAL/PRESCRIPTION)

Class B (addiction treatments, antihistamines, expectorants 9

Class B (decongestants, nasal sprays) 10

Class B (muscle relaxants, sleep aids, asthma, steroids) 11

Class B (gastrointestinal, vertigo/motion sickness) 12

(GENERALLY SAFE TO TAKE)

Class C (Alzheimer’s, analgesics, antibiotics, anti-convulsants 13

Class C (Anti-Parkinsonians, expectorants, asthma, cardiovascular 14

Class C (diabetes, erectile dysfunction, genitourinary, glaucoma,

gout, nasal sprays) 15

Class C (non-steroidal, inhibitors, osteoporosis, psychotropics,

sleep aids, thyroid) 16

Alcohol-Free Products 17-21

Non-Prescription & Prescription Products That Contain Alcohol 22

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INTRODUCTION

There are many types of medications which may present a hazard to a person beginning the journey

of recovery from chemical dependency. These include prescription and over-the-counter

medications. The danger is not always that a recovering addict may develop a new addiction – though

this certainly can happen – but that one can be led back into dependence on their drug of choice.

The latest scientific research has proven that all the dependence-producing drugs act on the brain

in the same way to produce addiction – despite having different effects or a different kind of “high”

when taken. In addition, if urine drug screening is part of the recovering person’s continuing

treatment program, use of many types of medications can result in falsely positive tests for the

more highly addictive classes of drugs, resulting in negative consequences.

Therefore, it is very important for a recovering person to learn about the different types of

medications and drugs – and which ones present a special risk to continuing recovery and sobriety.

The commonly available medications and drugs are divided into three classes – A, B and C – to

indicate three levels of risk.

Class A drugs must be avoided completely, as they are well known to produce addiction and are the

most dangerous of all. Only under very unusual conditions can the Class A drugs be taken by a

recovering addict or alcoholic – and only when given by a physician or dentist. These exceptional

circumstances can include: severe illness and injuries including major surgery, car accidents and

other trauma, tests or procedures which can only be done under sedation or anesthesia. Medication

treatments for certain psychiatric conditions are in this category, as are medications used for drug

detoxification. The “street drugs” are also included in Class A.

The medications in Class B are also potentially very dangerous – especially when taken by recovering

persons without the guidance of a physician or another healthcare professional. However, under

certain circumstances, the Class B group can be taken safely under a physician’s care.

Class C medications are generally safe from the point of view of addiction recovery. However,

overuse of any medication – even the common over-the-counter remedies – can result in unwanted

side effects.

People who have struggled with drug addiction or alcoholism must remain aware of the tendency to

look for “external solutions for internal problems” – and should avoid taking ANY of these

medications on their own, in order to medicate emotions and feelings. The tools of recovery –

including participation at 12-Step fellowship meetings, working the Steps or talking with a sponsor,

counselor or doctor - provide safe and healthy ways to deal with the strong feelings that can come

up at any time in early sobriety.

Many recovering people also have other chronic illnesses or mental health issues, such as depression,

bipolar disorder, diabetes or hypertension, which require prescription anti-depressants and other

treatments to remain healthy. Staying clean and sober from drugs and alcohol often requires

continued use of this type of medication; stopping the prescribed treatments without a doctor’s

guidance can result in a relapse into active addiction.

The three classes of medications that appear on the following pages include both the brand name

(i.e.: “Valium”), as well as the generic name (i.e.: “diazepam”) – as the majority of prescription bottles

are labeled with the generic name. On the following pages, look for the BRAND NAME listed first,

followed by the (generic name) in parentheses. For “street drugs”, the COMMON NAME is listed

first, and the (chemical name or “slang” name) is in parentheses. For each drug group in Class A and

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B, there is also a brief explanation of the dangers associated with taking the medication or street

drug.

At the end of the document there are two tables. The first is a list of alcohol-free products

grouped by therapeutic category. The manufacturer is listed next to each product name. The

second is a table of alcohol-containing medications.

Please remember, this information does not include all drugs and is only intended as a quick

reference because manufacturers change product ingredients and brand names frequently.

This guide is not intended to be a substitute for advice that only your own personal physician

can provide. In particular, it is VERY IMPORTANT that on the basis of the information

contained in this guide, you do not suddenly discontinue or make any changes in the doses of

medication that you may have been prescribed. Doing so may result in unexpected problems -

such as withdrawal reactions - which in some cases can be life-threatening. You MUST check

with your doctor before making ANY medication changes.

It is also essential that you inform ALL of your personal physicians, dentists and other health

care providers of your chemical dependency history so that medications can be prescribed

safely and appropriately when they are deemed necessary.

The bottom line is that a recovering addict or alcoholic needs to become a good consumer, and ask a

healthcare professional if there are questions about taking ANY kind of medication – BEFORE taking

it.

Remember that “RECOVERY IS ITS OWN REWARD” – being healthy and regaining a happy life is

YOUR responsibility!

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Bruce Merkin, MD

Glenbeigh Hospital

February 2007

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Medications and the Recovering Person

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Class A (avoid absolutely) Alcohol:

Ale Malt Beverage

Beer (including “non-alcoholic” forms) Whiskey

Brandy Wine

Liqueur Wine Cooler

Alcohol consumption reduces social inhibitions and produces pleasure and a sense of well-being. It is

a stimulant (raises blood pressure and heart rate) and a depressant. Alcohol affects the brain’s

reward pathways and appears to be related to interactions with dopamine, GABA, serotonin, opioid

and NMDA neurotransmitter systems. The “non-alcohol” or “NA” forms of beer should not be

consumed because there is a small amount of alcohol present and research shows that smell may be

enough to trigger cravings and a subsequent relapse among certain alcoholics. Please note that there

is a variety of cough and cold preparations that contain alcohol and that medications which can be

taken in tablet form will not contain ethyl alcohol. Certain topical products, soft-gels and capsules

contain ethyl alcohol and should be avoided. Please refer to the table at the end of the document

for a list of alcohol containing products to avoid.

Antitussives/Expectorants:

Ambenyl (codeine/bromodiphenhydramine) Hydromet (hydrocodone/homatropine)

Duratuss HD (hydrocodone/dextromethorphan) Mytussin (codeine/pseudoephedrine/guaifenesin)

Guiatuss (codeine/pseudoephedrine/guaifenesin) Nucofed (codeine/pseudoephedrine/guaifenesin)

Hycodan Tablets (hydrocodone/homatropine) Phenergan with Codeine (codeine/promethazine)

Hycodan Syrup (hydrocodone/homatropine) Robitussin AC (codeine/guaifenesin)

Hycomine (hydrocodone/chlorpheniramine/ Tussionex PennKinetic

phenylephrine/acetaminophen/caffeine) (hydrocodone/chlorpheniramine)

Hycotuss (hydrocodone/guaifenesin) Vicodin Tuss (hydrocodone/guaifenesin)

Any cough medications containing narcotics such as codeine or hydrocodone should not be used.

These medications bind to opiate receptors in the central nervous system, altering the perception of

and response to pain and produce generalized central nervous system depression and may alter mood

or cause sedation.

Barbiturates:

Amytal (amobarbital) Esgic (acetaminophen/butalbital/caffeine)

Barbita, (phenobarbital) Fioricet (butalbital/acetaminophen/caffeine)

Butisol (butabarbital) Fiorinal (butalbital/aspirin/ caffeine)

Donnatal (phenobarbital/atropine/hyoscyamine/ Nembutal (pentobarbital)

scopolamine) Seconal (secobarbital)

These medications can produce central nervous system depression ranging from mild (sedation) to

hypnotic (sleep induction). As the dose is increased, coma and death can occur. These medications

can also lead to an unusual excitatory response in some people.

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Class A (avoid absolutely)

Benzodiazepines:

Ativan (lorazepam) Restoril (temazepam)

Centrax (prazepam) Serax (oxazepam)

Dalmane (flurazepam) Tranxene (chlorazepate)

Doral (quazepam) Valium (diazepam)

Halcion (triazolam) Versed (midazolam)

Klonopin (clonazepam) Xanax (alprazolam)

Librium (chlordiazepoxide)

These medications can produce an immediate change in mood or affect and can cause central nervous

system depression (dose related) resulting in sedation, dizziness, confusion, or ataxia, which may

impair physical and mental capabilities. Abrupt discontinuation or a large decrease in dose can lead

to seizures, coma or death.

Other Central Nervous System Depressants:

GHB (G, gamma-hydroxybutyrate, everclear)

This category depresses the central nervous system possibly leading to: confusion; psychosis;

paranoia; hallucinations; agitation; depression; seizures; respiratory depression; decreases in level of

consciousness; coma and death.

Hallucinogens:

Cannabis (grass, green marijuana, pot, weed) Mescaline (peyote)

DMT (dimethyltryptamine) PCP (angel dust, phencyclidine)

Ketamine (special K) Psilocybin (magic mushroom, ‘shrooms)

LSD (acid, blotter, paper, sunshine, window pane) 2-CB

Marinol (dronabinol) 5-MeO-DIPT (foxy methoxy)

MDMA (E, eckies, ecstasy, love drug, X, XTC) STP (DOM)

Hallucinogens act in the central nervous system; using these substances can possibly lead to memory

disturbances, psychosis and vivid hallucinations. Marinol is the psychoactive substance in marijuana

and may cause withdrawal symptoms if stopped suddenly.

Inhalants:

Aerosols (hair sprays, deodorants) Nail Polish Remover (acetone)

Airplane Glue Paint (butane, propane, toluene)

Amyl Nitrate (poppers) Solvents (paint thinner, gasoline, glue, correction

Butyl Nitrate (room deodorizer) fluid, felt tip marker)

Gases (ether, chloroform, nitrous oxide, butane Varnish (xylene, toluene)

lighters, propane tanks, whipped cream dispensers)

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Class A (avoid absolutely) Inhalants:

Inhalants are central nervous system depressants. Use of inhalants can cause sedation and loss of

inhibitions possibly leading to liver, kidney, nerve, heart, brain, throat, nasal, and lung damage up to

and including coma and death.

Neuropathic Pain:

Lyrica (pregabalin)

Lyrica acts in the central nervous system as a depressant and can lead to withdrawal symptoms upon

discontinuation. It also produces euphoria in certain individuals.

Opioids:

Actiq (fentanyl oral transmucosal) OxyContin (oxycodone)

Buprenex (buprenorphine) OxyIR (oxycodone)

Combunox (oxycodone/ibuprofen) Percocet (oxycodone/acetaminophen)

Darvocet (propoxyphene napsylate/acetaminophen) Percodan (oxycodone/aspirin)

Darvon (propoxyphene hydrochloride) Roxanol (morphine sulfate)

Demerol (meperidine) Roxicet (oxycodone/acetaminophen)

Dilaudid (hydromorphone) Roxicodone (oxycodone)

Dolophine (methadone) Soma Compound with Codeine

Duragesic (fentanyl transdermal) (codeine/carisoprodol/aspirin)

Endocet (oxycodone/acetaminophen) Stadol (butorphanol)

Heroin (down, H, horse, smack) Suboxone (buprenorphine/naloxone) Kadian (morphine sulfate) Subutex (buprenorphine) Lorcet (hydrocodone/acetaminophen) Talacen (pentazocine/acetaminophen)

Lortab (hydrocodone/acetaminophen) Talwin (pentazocine lactate)

Methadose (methadone) Tylenol #2, #3 or #4 (codeine/acetaminophen)

MS Contin (morphine sulfate) Ultram (tramadol)

Norco (hydrocodone/acetaminophen) Vicodin (hydrocodone/acetaminophen)

Nubain (nalbuphine HCl)

Opioids bind to opiate receptors in the central nervous system causing inhibition of ascending pain

pathways and altering the perception of and response to pain. Generalized central nervous system

depression is also produced. Tolerance or drug dependence may result from extended use.

Buprenorphine binds to mu receptors in the brain leading to a suppression of withdrawal and cravings

but also feeling of euphoria. Most of the drugs in this class have the potential for drug dependency

and abrupt cessation may precipitate withdrawal.

Gastrointestinal (Anti-Diarrheals)

Lomotil (atropine/diphenoxylate) Motofen (atropine/difenoxin)

Diphenoxylate is a member of the opioid class of drugs. Atropine is added to discourage abuse for

recreational purposes. At recommended doses, the atropine causes no effects but in larger doses,

unpleasant symptoms are experienced. These medications should not be used because high doses

may cause physical and psychological dependence with prolonged use

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Class A (avoid absolutely)

Other Sedative-Hypnotics:

Ambien (zolpidem) Noctec (chloral hydrate)

Doriden (glutethimide) Placidyl (ethchlorvynol)

Librax (chlordiazepoxide/clidinium) Quaalude, Sopor (methaqualone)

Lunesta (eszopiclone) Soma (carisoprodol)

Midrin (acetaminophen/dichloralphenazone/ Soma Compound (carisoprodol/aspirin)

isometheptene) Sonata (zaleplon)

Miltown (meprobamate)

These drugs act on the central nervous system and have the potential for drug dependency and

abuse. Withdrawal symptoms can be seen if stopped suddenly.

Stimulants:

Adderall (amphetamine/dextroamphetamine) Meridia (sibutramine)

Adipex-P (phentermine) Metadate (methylphenidate)

Cocaine (blow, coke, crack, rock, snow, white) Methamphetamine (crank, crystal meth, glass, ice,

Concerta (methylphenidate) speed)

Cylert (pemoline) Methylin (methylphenidate)

Dexedrine (dextroamphetamine) Preludin (phenmetrazine)

Fastin (phentermine) Ritalin (methylphenidate)

Focalin (dexmethylphenidate) Tenuate (diethylpropion)

The stimulants cause physical and psychological addiction, impair memory and learning, hearing and

seeing, speed of information processing and problem-solving ability.

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Class B (only take with your doctor’s approval or prescription)

***NOTE: Although the medications listed below in the “Addiction Treatments” section are specifically intended

to be taken for prevention of relapse to dependence upon one or more drugs, none of them are habit-forming or

addictive themselves, and should therefore be considered safe for recovering people to take. However, their

proper use in the context of a recovery program requires monitoring by a health care professional, and it is for

this reason that we place them in Class B.***

Addiction Treatments:

Antabuse (disulfiram) Revia (naltrexone)

Campral (acamprosate) Symmetrel (amantadine)

Catapres (clonidine) Zyban (bupropion)

Chantix (varenicline)

Naltrexone may precipitate intense withdrawal symptoms in patients addicted to opiates. Clonidine

acts via autoreceptors in the locus coeruleus to suppress adrenergic hyperactivity there that is

involved in the expression of the opioid withdrawal syndrome. Disulfiram is dangerous if taken with

alcohol. Amantadine can cause decreased mental alertness or altered coordination. Chantix and

Zyban are medications to help with nicotine (cigarettes, cigars, chewing tobacco, snuff) addiction.

Cough and Cold Preparations: Antihistamines (Sedating)

Atarax (hydroxyzine hydrochloride) Polarmine (dexchlorpheniramine)

Benadryl (diphenhydramine) OTC Tavist (clemastine) OTC

Chlor-Trimeton (chlorpheniramine) OTC Teldrin (chlorpheniramine) OTC Dimetane (brompheniramine) OTC Vistaril (hydroxyzine pamoate)

Efidac (chlorpheniramine) OTC

Periactin (cyproheptadine)

Sedating antihistamines should be used with caution because they have the potential to alter

judgment and cause fatigue or sedation.

Antitussives/Expectorants

Benylin Cough (dextromethorphan) OTC Nyquil (dextromethorphan/alcohol) OTC

Comtrex (dextromethorphan) OTC Phenergan DM (promethazine/dextromethorphan)

Contac (dextromethorphan) OTC Robitussin DM (dextromethorphan/guaifenesin)

Delsym (dextromethorphan) OTC Vicks Formula 44D (dextromethorphan) OTC

Mucinex DM (dextromethorphan/guaifenesin) OTC

Any preparation containing dextromethorphan should be used with caution because

dextromethorphan acts on opioid receptors in the brain. Respiratory depression and perceptual

distortions can also be seen in those people taking large doses.

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Medications and the Recovering Person ��


Cough and Cold Preparations: Decongestants (Many are Combination Products)

Actifed (pseudoephedrine/triprolidine) OTC Mucinex D (pseudoephedrine/guaifenesin) OTC

AH-chew D (phenylephrine) OTC Nalex-A (phenylephrine) OTC Alavert D (loratadine/pseudoephedrine) OTC Novafed (pseudoephedrine) OTC Allegra D (fexofenadine/pseudoephedrine) Profen (pseudoephedrine) OTC Benzedrex Nasal Inhaler (propylhexamine) OTC Prolex-D (phenylephrine) OTC

Bromfed (phenylephrine/brompheniramine) R-Tannate Pediatric (phenylephrine/

Bromfed DM (pseudoephedrine/ chlorpheniramine/pyrilamine)

brompheniramine/dextromethorphan) Rondec (phenylephrine/chlorpheniramine)

Cardec DM (pseudoephedrine/ Rondec DM (phenylephrine/chlorpheniramine/

carbinoxamine/dextromethorphan) dextromethorphan)

Clarinex D (desloratadine/pseudoephedrine) Rynatan-S (phenylephrine/chlorpheniramine/

Claritin D (loratadine/pseudoephedrine) OTC pyrilamine)

Deconamine SR (pseudoephedrine/ Semprex-D (pseudoephedrine/acrivastine)

chlorpheniramine) OTC Sinutuss DM (phenylephrine) OTC

Dimetapp (pseudoephedrine/brompheniramine)OTC Sudafed (pseudoephedrine) OTC

Duratuss (pseudoephedrine/guaifenesin) Tussafed-EX (phenylephrine) OTC

Entex LA (phenylephrine/guaifenesin) Zyrtec D (cetirizine/pseudoephedrine)

Entex PSE (pseudoephedrine/guaifenesin)

Humibid DM (pseudoephedrine/

dextromethorphan/potassium guaiacolsulfonate)

Decongestants should be used with caution because they are stimulating and can trigger relapse.

Nasal Sprays

Afrin (oxymetazoline) OTC Neo-synephrine (phenylephrine) OTC

Astelin (azelastine) Nostrilla (oxymetazoline) OTC

Dristan (oxymetazoline) OTC Rhinocort Aqua (budesonide)

Flonase (fluticasone) Vicks Nasal Inhaler (desoxyephedrine) OTC

Nasacort AQ or HFA (triamcinolone) Vicks Sinex (phenylephrine) OTC

Nasonex (mometasone) 4-Way Nasal Spray (phenylephrine) OTC

All OTC nasal sprays should be used for a short period of time. If used for a long period of time

symptoms may worsen. Use for a maximum of 5 days. Intranasal corticosteroids (non-OTC) may

cause a reduction in growth velocity in pediatric patients.

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Muscle Relaxants:

Flexeril (cyclobenzaprine) Robaxin (methocarbamol)

Norflex (orphenadrine) Skelaxin (metaxalone)

Parafon Forte (chlorzoxazone) Zanaflex (tizanidine)

Muscle relaxants can cause central nervous system depression (sedation, dizziness), which may

impair physical or mental abilities.

Sleep Aids:

Excedrin PM (diphenhydramine) OTC Sominex (diphenhydramine) OTC

Nytol (diphenhydramine) OTC Tylenol PM (diphenhydramine/acetaminophen)

OTC

Sleep-eze (diphenhydramine) OTC Unisom (diphenhydramine) OTC

Sleep aids act in the central nervous system and can alter judgement and cause sedation.

Others: Asthma

Primatene Mist (epinephrine) OTC

Primatene Mist can cause nervousness, restlessness, sleeplessness, palpitations, tachycardia, chest

pain, muscle tremors, dizziness and flushing.

Steroids

Decadron (dexamethasone) Medrol (methylprednisolone)

Deltasone (prednisone)

It is important to take steroids exactly as directed. Long term use requires a taper off of the drug.

Steroid use can decrease the immune system leading to increased infections. Insomnia, nervousness

and a variety of other side effects are also common.

Asthma/COPD/Pulmonary (Inhaled Corticosteroids/Long-Acting Beta 2

Agonists)

Advair Diskus (fluticasone/salmeterol) Pulmicort (budesonide)

Azmacort (traimcinolone) Serevent Diskus (salmeterol)

Flovent (fluticasone) QVAR (beclomethasone)

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Asthma/COPD/Pulmonary (Inhaled Corticosteroids/Long-Acting Beta 2

Agonists)

Particular care is required when patients are transferred from systemic corticosteroids to inhaled

products due to possible adrenal insufficiency or withdrawal from steroids, including an increase in

allergic symptoms. Regular use may suppress the immune system. Orally-inhaled corticosteroids

may cause a reduction in growth velocity in pediatric patients. Advair and Serevent can cause

central nervous system excitement.

Gastrointestinal (Constipation)

Dulcolax (bisacodyl) OTC Senokot (senna) OTC

Ex-Lax (senna) OTC

Continued use of laxatives can lead to dependency for colon function. Use for only a short period of

time.

Gastrointestinal (Nausea/Vomiting)

Compazine (prochlorperazine) Tigan (trimethobenzamide)

Phenergan (promethazine) Zofran (ondansetron)

These medications affect the central nervous system and can cause sedation.

Vertigo/Motion Sickness

Antivert (meclizine) Transderm Scop (scopolamine)

Dramamine (dimenhydrinate) OTC

These medications affect the central nervous system and can cause dizziness, drowsiness, or

blurred vision.

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Class C (generally safe to take)

Alzheimer’s: Aricept (donepezil) Namenda (memantine)

Exelon (rivastigmine) Razadyne (galantamine)

Analgesics (Migraine): Amerge (naratriptan) Maxalt (rizatriptan)

Axert (almotriptan) Relpax (eletriptan)

Frova (frovatriptan) Zomig (zolmitriptan)

Imitrex (sumatriptan)

Analgesics (Other): Tylenol (acetaminophen) OTC

Anti-Convulsants (Also Mood Stabilizers): Carbatrol (carbamazepine) Neurontin (gabapentin)

Depakote (divalproex sodium) Tegretol (carbamazepine)

Dilantin (phenytoin) Topamax (topiramate)

Keppra (levetiracetam) Trileptal (oxcarbazepine)

Lamictal (lamotrigine) Zonegran (zonisamide)

Antihistamines (Non-sedating):

Alavert (loratadine) OTC Claritin (loratadine) OTC

Allegra (fexofenadine) Zyrtec (cetirizine)

Clarinex (desloratadine)

Antibiotics/Antivirals Amoxil (amoxicillin) Levaquin (levofloxain)

Augmentin (amoxicillin/clavulanate) Lorabid (loracarbef)

Avelox (moxifloxacin) Macrobid (nitrofurantoin

monohydrate/macrocrystals)

Bactrim (sulfamethoxazole/trimethoprim) Macrodantin (nitrofurantoin macrocrystals)

Biaxin (clarithromycin) Minocin (minocycline)

Ceclor (ceflacor) Omnicef (cefdinir)

Ceftin (cefuroxime) Pen-Vee K (penicillin)

Cefzil (cefprozil) Relenza (zanamavir)

Cipro (ciprofloxacin) Sporanox (itraconazole)

Cleocin (clindamycin) Sumycin (tetracycline)

Diflucan (fluconazole) Tamiflu (oseltamavir) Doryx (doxycycline) Tequin (gatifloxacin) Duricef (cefadroxil) Valtrex (valacyclovir)

E-Mycin (erythromycin) Vantin (cefpodoxime)

Flagyl (metronidazole) Vibramycin (doxycycline)

Keflex (cephalexin) Zithromax (azithromycin)

Ketek (telithromycin) Zovirax (acyclovir)

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Anti-Parkinsonians: Mirapex (pramipexole) Sinemet (carbidopa/levodopa)

Requip (ropinirole)

Antitussives/Expectorants: Humibid LA (guaifenesin/potassium Mucinex (guaifenesin) OTC

guaiacolsulfonate) Tessalon Perles (benzonatate)

Asthma/COPD/Pulmonary:

Accolate (zafirlukast) Singulair (montelukast)

Atrovent (ipratropium) Spiriva (tiotropium)

Combivent (albuterol/ipratropium) Theo-24 (theophylline)

Proventil/Ventolin (albuterol) Xopenex (levalbuterol)

Benign Prostatic Hypertrophy (Also Cardiovascular): Cardura (doxazosin) Hytrin (terazosin)

Flomax (tamsulosin) Proscar (finasteride)

Cardiovascular (Antihypertensives, Anticoagulants, Antiplatelets,

Cholesterol Lowering, Diuretics): Accupril (quinapril) Isordil (isosorbide dinitrate)

Aldactone (spironolactone) Lanoxin (digoxin)

Altace (ramipril) Lasix (furosemide)

Aspirin Lipitor (atorvastatin)

Atacand (candesartan) Lopid (gemfibrozil)

Avalide (irbesartan/hydrochlorothiazide) Lopressor (metoprolol)

Avapro (irbesartan) Lotensin (benazepril)

Benicar (olmesartan) Lotrel (amlopidine/benazepril)

Betapace (sotalol) Lovenox (enoxaparin)

Bumex (bumetadine) Monopril (fosinopril)

Calan (verapamil) Niaspan (Niacin)

Cardizem (diltiazem) Nitro-Bid (nitroglycerin)

Coreg (carvedilol) Norvasc (amlopidine)

Coumadin (warfarin) Plavix (clopidogrel)

Cozaar (losartan) Pravachol (pravastatin)

Crestor (rosuvastatin) Prinivil (lisinopril)

Demadex (torsemide) Sular (nisoldipine)

Diovan (valsartan) Tenormin (atenolol)

Dyazide (hydrochlorothiazide/triamterene) Tricor (fenofibrate)

Heparin Vasotec (enalapril)

Hydrodiuril (hydrochlorothiazide) Vytorin (ezetimibe/simvastatin)

Hyzaar (losartan/hydrochlorothiazide) Zestril (lisinopril)

Imdur (isosorbide mononitrate) Zetia (ezetimibe)

Inderal (propranolol) Zocor (simvastatin)

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Diabetes Mellitus: Actos (pioglitazone) Humalog (insulin lispro)

Amaryl (glimepiride) Humulin L,N,R,U (insulin)

Avandia (rosiglitazone) Lantus (insulin glargine)

Diabeta (glyburide) Novolin 70/30, N or R (insulin)

Glucophage (metformin) Novolog (insulin aspart)

Glucotrol (glipizide)

Erectile Dysfunction: Cialis (tadalafil) Viagra (sildenafil)

Levitra (vardenafil)

Gastrointestinal (Antacids, Antidiarrheals, Anitspasmosdics, Antiulcers,

Constipation, Nausea/Vomiting): Aciphex (rabeprazole) Pepcid (famotidine) OTC

Bentyl (dicyclomine) Pepto-Bismol (bismuth subsalicylate) OTC

Colace (docusate sodium) OTC Prevacid (lansoprazole)

Emetrol (phosphorylated carbohydrate) OTC Prilosec (omeprazole) OTC

Imodium (loperamide) OTC Protonix (pantoprazole)

Kaopectate (bismuth subsalicylate) OTC Reglan (metoclopramide)

Maalox OTC Simethicone OTC

Mylanta OTC Tums OTC

Nexium (esomeprazole) Zantac (ranitidine) OTC

Genitourinary: Detrol (tolterodine) Ditropan (oxybutinin)

Glaucoma: Alphagan P (brimonidine) Timoptic (timolol)

Azopt (brinzolamide) Travatan (travoprost)

Cosopt (dorzolamide/timolol) Trusopt (dorzolamide)

Lumigan (bimatoprost) Xalatan (latanoprost)

Gout: Zyloprim (allopurinol)

Nasal Sprays: Atrovent (ipratropium) NaSal (saline) OTC

Ayr (saline) OTC NasalCrom (cromolyn) OTC

HuMist (saline) OTC Ocean Spray (saline) OTC

16

��



Non-Steroidal Anti-inflammatory Drugs: Advil (ibuprofen) OTC Mobic (meloxicam)

Aleve (naproxen) OTC Motrin (ibuprofen) OTC

Anaprox (naproxen) Naprosyn (naproxen)

Cataflam (diclofenac potassium) Orudis (ketoprofen)

Daypro (oxaprozin) Relafen (nabumetone)

Indocin (indomethacin) Toradol (ketorlac)

Lodine (etodolac) Voltaren (diclofenac sodium)

COX-2 inhibitors Celebrex (celecoxib)

Osteoporosis (Calcium Metabolism): Actonel (risedronate) Evista (raloxifene)

Boniva (ibandronate) Fosamax (alendronate)

Psychotropics: Abilify (aripiprazole) Pamelor (nortriptyline)

Buspar (buspirone) Paxil (paroxetine)

Celexa (citalopram) Prozac (fluoxetine)

Clozaril (clozapine) Remeron (mirtazapine)

Cymbalta (duloxetine) Risperdal (risperidone)

Depakote (divalproex sodium) Seroquel (quetiapine)

Desyrel (trazodone) Serzone (nefazodone)

Effexor (venlafaxine) Sinequan (doxepin)

Elavil (amitriptyline) Sinequan (doxepin)

Eskalith (lithium) Strattera (atomoxetine)

Geodon (ziprasidone) Wellbutrin (bupropion)

Haldol (haldoperidol) Zoloft (sertraline)

Lexapro (escitalopram) Zyprexa (olanzapine)

Luvox (fluvoxamine)

Sleep Aid: Rozerem (ramelteon)

Thyroid: Armour thyroid (thyroid desiccated) Levoxyl (levothyroxine)

Levothroid (levothyroxine) Synthroid (levothyroxine)

��

Compiled by Renee Enstrom, Pharm D Candidate (LECOM School of Pharamcy), Bruce J. Merkin, MD (Medical Director, Glenbeigh Hospital and Clinical

Instructor in Addiction Medicine, University Hospitals of Cleveland) and Nicholas Link, Pharm.D. Candidate (Ohio Northern University) based on material

provided by Paul H. Earley, MD, FASAM (Talbott Recovery Campus, Atlanta, GA). February 2007.

17

Alcohol-Free Products ��

The following is a selection of alcohol-free products grouped by therapeutic category. The list is not comprehensive.

Manufacturers change product ingredients and brand names frequently. Always check product labeling for definitive

information on specific ingredients. Manufacturers are listed after each product name.

Analgesics

Anti-Asthmatic Agents

Acetaminophen Infants Drops Ivax

Dilor-G Liquid (guaifenesin/dyphylline)

Savage

Actamin Maximum Strength Liquid (acetaminophen)

Cypress

Addaprin Tablet (ibuprofen)

Dover Elixophyllin-GG liquid (guaifenesin/theophylline)

Forest

Advil Children’s Suspension (ibuprofen)

Wyeth Consumer Anti-Convulsants

Aminofen Tablet (acetaminophen)

Dover Zarontin Syrup (Ethosuximide)

Pfizer

Aminofen Max Tablet (acetaminophen)

Dover Antiviral Agents

APAP Elixir (acetaminophen)

Bio-Pharm Epivir Oral Solution (Lamivudine)

GlaxoSmithKline

Aspirtab Tablet (aspirin)

Dover Cough/Cold/Allergy Preparations

Genapap Children Elixir (acetaminophen)

Ivax Accuhist Pediatric Drops (brompheniramine/ pseudoephedrine

Propst

Genapap Infant’s Drops (acetaminophen)

Ivax Alka Seltzer Plus Day Cold,

(acetaminophen,

dextromethorphan, phenylephrine

Bayer

Motrin Children’s Suspension (ibuprofen)

McNeil Consumer Alka Seltzer Plus Night Cold,

(acetaminophen, dextromethorphan,

phenylephrine, chlorpheniramine, doxylamine)

Bayer

Motrin Infants’ Suspension (ibuprofen)

McNeil Consumer

Silapap Children’s Elixir (acetaminophen)

Silarx

Allergy Relief Medicine

Children’s Elixir (diphenhydramine) Hi-Tech

Pharmacal

Silapap Infant’s Drops (acetaminophen)

Silarx

Tylenol Children’s Suspension (acetaminophen)

McNeil Consumer Andehist DM Drops

(carbinoxamine/ dextromethorphan)

Cypress

Tylenol Extra Strength Solution (acetaminophen)

McNeil Consumer Andehist DM Syrup

(carbinoxamine/ dextromethorphan) Cypress

Tylenol Infant’s Drops (acetaminophen)

McNeil Consumer Andehist DM NR Liquid

(carbinoxamine/dextromethorphan/p

seudoephedrine)

Cypress

Tylenol Infant’s Suspension (acetaminophen)

McNeil Consumer Andehist DM NR Syrup


seudoephedrine)

Cypress

Andehist NR Syrup

(carbinoxamine/pseudoephedrine) Cypress

18


Bayer Alka Seltzer Plus Cold &

Cough, (acetaminophen,

dextromethrophan, phenylephrine, chlorpheniramine)

Bayer Diabetic Tussin DM

Maximum Strength Liquid (guaifenesin/dextromethorphan)

Healthcare

Products

Benadryl Allergy

Solution(diphenhydramine) Pfizer Consumer Diabetic Tussin DM

Maximum Strength Capsule

(guaifenesin/dextromethorphan)

Healthcare

Products

Biodec DM Drops


seudoephedrine)

Bio-Pharm Diabetic Tussin EX Liquid (guaifenesin)

Healthcare

Products

Biodec DM Syrup


seudoephedrine)

Bio-Pharm Diabetic Tussin Nighttime

Formula Cold/Flu Relief, (dextromethrophan, acetaminophen,

diphenhydramine

Healthcare

Products

Broncotron Liquid

(pseudoephedrine)

Seyer Pharmatec Dimetapp Cold & Fever

Children’s Suspension (ibuprofen/pseudoephedrine)

Wyeth

Consumer

Buckleys Mixture,

(dextromethorphan)

Novartis Double-Tussin DM Liquid (guaifenesin/dextromethorphan)

Reese

Carbatuss Liquid (phenylephrine/guaifenesin)

GM Dynatuss Syrup (carbinoxamine/pseudoephedrine/

dextromethorphan)

Breckenridge

Cepacol Sore Throat Liquid (benzocaine)

J.B. Williams Dynatuss EX Syrup (guaifenesin/dextromethorphan/

pseudoephedrine)

Breckenridge

Children’s Benadryl Allergy,

(diphenhydramine)

Pfizer Entex Syrup (phenylephrine/guaifenesin)

Andrx

Chlor-Trimeton Allergy Syrup (chlorpheniramine)

Schering Plough Father John’s Medicine

Plus Drops (chlorpheniramine/

phenylephrine/dextromethorphan/

guaifenesin/ammonium chloride)

Oakhurst

Codal-DM Syrup (dextromethorphan/phenylephrine/

pyrilamine)

Cypress Friallergia DM Liquid (brompheniramine/pseudoephedrine

/dextromethorphan)

R.I.D.

Creomulsion Complete Syrup (chlorpheniramine/pseudoephedrine/

dextromethorphan)

Summit Industries Friallergia Liquid (brompheniramine/pseudoephedrine

)

R.I.D.

Creomulsion Cough Syrup (dextromethorphan)

Summit Industries Gani-Tuss-DM NR Liquid (guaifenesin/dextromethorphan)

Cypress

Creomulsion For Children Syrup (dextromethorphan)

Summit Industries Genahist Elixir (diphenhydramine)

Ivax

Creomulsion Pediatric Syrup (chlorpheniramine/pseudoephedrine/

dextromethorphan)

Summit Industries Giltuss Pediatric Liquid (guaifenesin/dextromethorphan/

pseudoephedrine)

Gil

Delsym Cough Suppressant

(dextromethorphan)

Cell Tech Giltuss Liquid (guaifenesin/dextromethorphan/

pseudoephedrine)

Gil

Despec Liquid (chlorpheniramine/pseudoephedrine/

dextromethorphan/guaifenesin/

phenylephrine)

International

Ethical

Guaicon DMS Liquid (guaifenesin/dextromethorphan)

Textilease

Medique

Diabetic Tussin Allergy

Relief Liquid (chlorpheniramine)

Healthcare Products Guai-Dex Liquid (guaifenesin/dextromethorphan)

Alphagen

Diabetic Tussin DM Liquid (guaifenesin/dextromethorphan)

Healthcare Products Guaifed Syrup (phenylephrine/pseudoephedrine/

guaifenesin)

Muro

19


Hayfebrol Liquid (chlorpheniramine/pseudoephedrine)

Scot-Tussin Panmist-S Syrup (guaifenesin/pseudoephedrine)

Pamlab

Histex Liquid (chlorpheniramine/pseudoephedrine)

TEAMM PediaCare Cold + Allergy

Children’s Liquid (chlorpheniramine/pseudoephedrine)

Pharmacia

Histex PD Drops (carbinoxamine)

TEAMM PediaCare Cough + Cold

Children’s Liquid (chlorpheniramine/

pseudoephedrine/dextromethorphan)

Pharmacia

Histex PD Liquid (carbinoxamine)

TEAMM PediaCare Nightrest Liquid (chlorpheniramine/pseudoephedrine/

dextromethorphan)

Pharmacia

Hydramine Elixir (diphenhydramine)

Ivax Pediahist DM Syrup (brompheniramine/pseudoephedrine/d

extromethorphan/guaifenesin)

Boca

Hydro-Tussin DM Elixir (guaifenesin/dextromethorphan)

Ethex Pedia-Relief Liquid (chlorpheniramine/pseudoephedrine/

dextromethorphan)

Major

Kaopectate, (bismuth

subsalicyate)

Pfizer Pediatex Liquid (carbinoxamine)

Zyber

Kita La Tos Liquid


R.I.D. Pediatex-D Liquid (carbinoxamine/pseudoephedrine)

Zyber

Lodrane Liquid (brompheniramine/pseudoephedrine)

ECR Phanasin Syrup (guaifenesin)

Pharmakon

Medi-Brom Elixir (brompheniramine/pseudoephedrine/

dextromethorphan)

Medicine Shoppe Phanatuss Syrup (guaifenesin)

Pharmakon

Motrin Cold Children’s

Suspension (ibuprofen/pseudoephedrine)

McNeil Consumer Phena-S Liquid (chlorpheniramine/phenylephrine)

GM

Nalex-A Liquid (chlorpheniramine/phenylephrine)

Blansett Pharmacal Poly-Tussin DM Syrup (chlorpheniramine/phenylephrine/

dextromethorphan)

Poly

Nalspan Senior DX Liquid (guaifenesin/dextromethorphan)

Morton Grove Primsol Solution (trimethoprim)

Medicis

Neotuss-D Liquid (chlorpheniramine/pseudoephedrine/

dextromethorphan/guaifenesin)

A.G. Marin Prolex DM Liquid (guaifenesin/dextromethorphan)

Blansett

Pharmacal

Norel DM Liquid (chlorpheniramine/phenylephrine/

dextromethorphan)

U.S. Pharmaceutical Quintex Syrup (phenylephrine/guaifenesin)

Qualitest

Orgadin Liquid (guaifenesin)

American Generics Robitussin Cough & Congestion

Liquid (chlorpheniramine/

pseudoephedrine/dextromethorphan/

guaifenesin/acetaminophen)

Wyeth

Consumer

Organidin NR Liquid (guaifenesin)

Wallace Robitussin Cough & Cold Nightime (chlorpheniramine, dextromethorphan,

phenylephrine)

Wyeth

Palgic-DS Syrup

(carbinoxamine/pseudoephedrine

)

Pamlab Robitussin Cough & Allergy

(chlorpheniramine,


Wyeth

Panmist DM Syrup (guaifenesin/dextromethorphan/

pseudoephedrine)

Pamlab Robitussin Cough & Cold CF

(dextromethorphan, guaifenesin,

phenylephrine)

Wyeth

20


Robtiussin Cold & Flu Nightime (acetaminophen, chlorpheniramine,

dextromethorphan, phenylephrine)

Wyeth Sudatuss DM Syrup (chlorpheniramine/dextromethorphan

/pseudoephedrine)

Pharmaceutical

Generic

Robitussin DM Liquid


Wyeth Consumer Tussafed Syrup (chlorpheniramine/carbinoxamine/


Everett

Robitussin PE Syrup (pseudoephedrine/guaifenesin)

Wyeth Consumer Tussafed-EX Syrup pseudoephedrine/dextromethorphan/

guaifenesin)

Everett

Robitussin Pediatric Drops (guaifenesin/dextromethorphan/

pseudoephedrine)

Wyeth Consumer Tuss-DM Liquid (chlorpheniramine/phenylephrine/

guaifenesin/dextromethorphan

Seatrace

Robitussin Pediatric Night Relief

Liquid (chlorpheniramine/

dextromethorphan/pseudoephedrine)

Wyeth Consumer Tussi-Organidin DM NR Liquid (guaifenesin/dextromethorphan)

Wallace

Scot-Tussin Allergy

Relief Formula Liquid (diphenhydramine)

Scot-Tussin Tussi-Pres Liquid (guaifenesin/dextromethorphan/

pseudoephedrine)

Kramer-Novis

Scot-Tussin DM Liquid (chlorpheniramine/dextromethorphan

/guaifenesin)

Scot-Tussin Tylenol Cold Children’s Liquid (chlorpheniramine/pseudoephedrine/

acetaminophen)

McNeil

Consumer

Scot-Tussin Expectorant Liquid (guaifenesin)

Scot-Tussin Tylenol Cold Infants’ Drops (acetaminophen/pseudoephedrine)

McNeil

Consumer

Scot-Tussin Original Syrup (phenylephrine)

Scot-Tussin Tylenol Flu Children’s Suspension (chlorpheniramine/pseudoephedrine/

dextromethorphan/acetaminophen)

McNeil

Consumer

Scot-Tussin Senior Liquid (guaifenesin/dextromethorphan)

Scot-Tussin Tylenol Flu Night Time Max

Strength Liquid (acetaminophen/

doxylamine/diphenhydramine/


McNeil

Consumer

Sildec Liquid (brompheniramine/pseudoephedrine/c

arbinoxamine)

Silarx Tylenol Sinus Children’s Liquid (acetaminophen/pseudoephedrine)

McNeil

Consumer

Sildec Syrup (brompheniramine/pseudoephedrine/

carbinoxamine)

Silarx Vicks Dayquil Multi-symptom

cold/flu relief (acetaminophen,


Procter &

Gamble

Sildec-DM Drops (brompheniramine/pseudoephedrine/c

arbinoxamine/dextromethorphan)

Silarx Vicks 44E Pediatric Liquid (guaifenesin/dextromethorphan)

Procter &

Gamble

Sildec-DM Syrup (brompheniramine/pseudoephedrine/

carbinoxamine/dextromethorphan)

Silarx Vicks 44M Pediatric Liquid (chlorpheniramine/pseudoephedrine/d

extromethorphan)

Procter &

Gamble

Siltussin DAS Liquid (guaifenesin)

Silarx Z-Cof DM Syrup (guaifenesin/dextromethorphan/

pseudoephedrine)

Zyber

Siltussin DM Syrup (guaifenesin/dextromethorphan)

Silarx

Ear/Nose/Throat Products

Siltussin DM DAS Cough

Formula Syrup (guaifenesin/dextromehtorphan)

Silarx 4-Way Saline Moisturizing

Mist Spray

Bristol

Siltussin SA Syrup (guaifenesin)

Silarx Ayr Baby Saline Spray

Ascher, B.F.

Simply Cough Liquid (dextromehtorphan)

McNeil Consumer Bucalcide Solution (benzocaine)

Seyer

Pharmatec

21


Bucalcide Spray (benzocaine)

Seyer Pharmatec Fleet Pain Relief Pads (pramoxine)

Fleet

Bucalsep Solution (benzocaine)

Gil Neutrogena Acne Wash Liquid Neutrogena

Bucalsep Spray (benzocaine)

Gil Neutrogena Antiseptic Liquid

Neutrogena

Cepacol Sore Throat Liquid (benzocaine)

Combe Neutrogena Clear Pore Gel Neutrogena

Gly-oxide Liquid (carbamide peroxide)

GlaxoSmithKline

Consumer

Neutrogena T/Derm Liquid Neutrogena

Orasept Mouthwash/

Gargle Liquid (benzocaine)

Pharmakon Labs Neutrogena Toner Liquid Neutrogena

Zilactin Baby Extra Strength Gel (benzocaine)

Zila Consumer Podiclens Spray (benzalkonium chloride)

Woodward

Gastrointestinal Agents Sea Breeze Foaming

Face Wash Gel

Clairol

Imogen Liquid (loperamide)

Pharmaceutical

Generic Vitamins/Minerals/Supplements

Kaopectate Suspension (bismuth subsalicylate)

Pharmacia

Consumer

Apetigen Elixir (vitamins A & E/multivitamin)

Pharmaceutical

Generic

Liqui-Doss Liquid (mineral oil)

Ferndale Genesupp-500 Liquid (multivitamin)

Pharmaceutical

Generic

Hematinics Genetect Plus Liquid (multivitamin/iron)

Pharmaceutical

Generic

Irofol Liquid (iron)

Dayton Multi-Delyn w/Iron Liquid (multivitamin/iron)

Silarx

Miscellaneous Poly-Vi-Sol Drops (multivitamin)

Mead Johnson

Cytra-2 Solution (sodium citrate salts)

Cypress Poly-Vi-Sol w/Iron Drops (multivitamin/iron)

Mead Johnson

Cytra-K Solution (sodium citrate salts)

Cypress Strovite Forte Syrup

(multivitamin/iron/folic acid) Everett

Emetrol Solution (phosphorated carbohydrate)

Pharmacia Consumer Supervite Liquid (multivitamin/B complex/

folic acid/multivitamin)

Seyer Pharmatec

Psychotropics Suplevit Liquid (multivitamin/iron)

Gil

Thorazine Syrup (chlorpromazine)

GlaxoSmithKline

Tri-Vi-Sol Drops (multivitamin)

Mead Johnson

Topical Products Tri-Vi-Sol w/Iron Drops (multivitamin/iron)

Mead Johnson

Aloe Vesta 2-N-1

Antifungal Ointment (miconazole)

Convatec

Vitafol Syrup (multivitamin/iron/folic

acid/vitamin E/calcium salts)

Everett

��

The APhA Complete Review for Pharamcy. 3rd ed. Gourley, Dick R. Castle Connolly graduate Medical Publishing , Ltd.

2005. 864-865.

22

A Partial List of Non-Prescription and Prescription

Products that Contain Alcohol * ��

5% Alcohol (10-Proof)

Diphenhydramine Elixir Kay Ciel Liquid (potassium)

Benylin Cough Syrup Guiatuss AC Syrup (guaifenesin/codeine)

Cheracol-D Cough Syrup (guaifenesin/dextromethorphan)

Phenergan VC Syrup (promethazine/phenylephrine)

Dihstine DH Elixir (chlorpheniramine/pseudoephedrine/codeine)

Tussend Syrup (guaifenesin/chlorpheniramine/pseudoephedrine/hydrocodone)

Dilaudid Cough Syrup (hydromorphone) Tylenol Extra Strength Liquid

Dramamine Liquid (dimenhydrinate) Tylenol with Codeine Elixir

Feosol (iron) Elixir Vicks 44 D (dextromethorphan/pseudoephedrine)

Imodium A-D (loperamide) Vicks 44 E (guaifenesin/dextromethorphan)

Kaon Liquid (potassium)


Excedrin PM Liquid (acetaminophen/diphenhydramine) Nucofed Expectorant Syrup (guaifenesin/pseudoephedrine/codeine)

Geritol Tonic Liquid (multivitamin) Nu-Iron Elixir (iron)

Hycotuss Expectorant Syrup (hydrocodone/guaifenesin)

Vicks Nyquil

(doxylamine/pseudoephedrine/dextromethorphan/acetamino

phen)

Niferex Elixir (iron) Vicks Formula 44M (chlorpheniramine/pseudoephedrine/dextromethorphan/aceta

minophen)


Cepacol Mouthwash Lomotil Liquid (diphenoxylate/atropine)

Gerivite Elixir (multivitamin)


Gevrabon Liquid (vitamins) Lufyllin Elixir (theophylline)

Listerine Mouthwash (flavored) Theophylline Elixir


Listerine Mouthwash (regular) N'ice Throat Spray

* Note Also: some prescription nasal sprays used for allergic rhinitis and some other forms of

nasal/sinus congestion contain alcohol. Alcohol-containing nasal sprays that should be avoided by

recovering persons, especially those taking Antabuse, include Flonase and Nasonex nasal sprays. The majority of mouthwashes contain alcohol also. These should all be avoided.

��

Copyright Meriter Hospital “Maintaining Sobriety: Making Alcohol-Free Choices”, 2004 "Reprinted with permission."

C: NURSiING/Meds & Recovering Person

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